MammoguideBreast Imaging Simplified

Breast DDx - Differential Diagnoses

One of the most essential skills in radiology is being able to recognize a finding, categorize it, and list the possible diagnoses. A lot of time is spent memorizing the differentials for an anterior mediastinal mass or a lytic bone lesion. Many times in breast imaging the differential can be simplified and narrowed down to "cancer" or "not cancer." Then a biopsy is used to sort it out. While this may be true, the concept of a differential diagnosis is still very relevant.

Concordance - The Secret To Success

Concordance = determining whether the histologic results make sense with the imaging findings

It is essential to know the possible diagnostic outcomes for a particular imaging finding in order to determine biopsy concordance. If you biopsy an area of architectural distortion and the pathology comes back showing abundant fat and usual ductal hyperplasia, this is not concordant. Further intervention is required. Determining concordance is one of the most important (and often overlooked) steps in performing a breast biopsy.

In order to effectively determine concordance after performing a breast biopsy, you need to know what are the acceptable pathologic outcomes. And this is where differential diagnoses come into play in breast imaging. Here are some of the most frequently used lists of differential diagnoses for common mammographic, sonographic or breast MRI radiologic findings. You will not find esoteric lists of extremely rare differentials. These are all high-yield, must know differentials.